Long-term endothelial dysfunction after trans-radial catheterization: A meta-analytic approach

Abstract

Transradial catheterization impairs endothelium dependent vasodilatory properties of the cannulated RA, which do not recover even several months post-catheterization. Non-recovery of vasomotor function of cannulated RAs may limit their use as arterial grafts during CABG surgery.

Radial artery access site complications during cardiac procedures, clinical implications and potential solutions: The role of nitric oxide

“…Pseudoaneurysm is an extremely rare complication in the RA approach (more common in transfemoral procedures) and occurs when an artery wall is injured, resulting in possible haemorrhage and haematoma in the surrounding tissue [11,26] . RA cannulation can also cause direct damage to the endothelium, which can affect RA function [38,39] impairing endotheliumdependent vasodilatory, anti-thrombotic and anti-mitogenic properties.…”

The radial artery: Results and technical considerations

“…Finally, surgeons should know whether the RA that is to be harvested has been recently cannulated during a diagnostic cardiac catheterization. There is evidence to suggest that transradial catheterization results in endothelial vasomotor dysfunction that may last for several months and could adversely affect graft patency . Caution should be exercised when considering the use of these conduits for CABG …”

Optimal management of radial artery grafts in CABG: Patient and target vessel selection and anti-spasm therapy

“…Concerns were also raised regarding the use of the RA following trans radial artery access for diagnostic or interventional procedures. In a meta‐analysis involving patients undergoing cardiac catheterization using the RA, Antonopoulus et al found that trans radial artery catheterization impaired endothelium‐dependent vasodilation of the RA and this persisted even after 3 months . This has raised concerns that surgeons should avoid using the RA as coronary grafts following any instrumentation including its cannulation in arterial blood pressure monitoring .…”